Streptococcus intermedius-associated late-onset endophthalmitis after trabeculectomy with adjunctive mitomycin C

J Glaucoma. 2009 Jan;18(1):79-80. doi: 10.1097/IJG.0b013e318170a732.

Abstract

Purpose: To report a woman with congenital rubella syndrome of delayed-onset, bleb-related endophthalmitis induced by Streptococcus intermedius.

Methods: Interventional case report.

Results: A 33-year-old woman who underwent bilateral trabeculectomy with adjunctive mitomycin C, 11 years earlier presented with redness and blurred vision in her right eye. She had received a topical antimicrobial agent because of bleb leak before presentation. She underwent anterior chamber tap and complete vitrectomy with intravitreal antibiotics. Cultures from the vitreous aspirate grew gram-positive cocci. The DNA from the microorganism was sequenced and identified as S. intermedius. Three months after the surgical intervention, her right eye showed no residual inflammation with a best-corrected visual acuity of 30/200.

Conclusions: Bleb-associated endophthalmitis caused by S. intermedius is responsive to intravitreal antibiotics and vitrectomy, and special care should be taken to identify a bacterial pathogen.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alkylating Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Combined Modality Therapy
  • DNA, Bacterial / analysis
  • Drug Therapy, Combination
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Female
  • Humans
  • Mitomycin / administration & dosage*
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology*
  • Streptococcus intermedius / genetics
  • Streptococcus intermedius / isolation & purification*
  • Trabeculectomy / adverse effects*
  • Vitrectomy
  • Vitreous Body / microbiology

Substances

  • Alkylating Agents
  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Mitomycin